FAQs about hyperacusis

Below you will find a list of questions which people tend to ask when they get in touch with me about hyperacusis, along with some hopefully helpful answers. Please note however that

I am not a medical professional

information given on this page is not medical advice

before acting on any of the information on this page you should discuss the matter with your GP or other qualified medical professional

I can't take any responsibility for any problems you may experience as a result of acting on any information provided on this page.

What is hyperacusis?

The NHS, Britain's health service, describes it as follows:

Hyperacusis is the name for intolerance to everyday sounds that causes significant distress and affects a person's day-to-day activities.

A slightly more in-depth definition of hyperacusis is provided by the Action on Hearing Loss charity, from their hyperacusis factsheet:

Hyperacusis is increased sensitivity to everyday sounds that causes discomfort and sometimes pain. People who have hyperacusis are very sensitive to sounds above a certain volume level, and often find everyday sounds, such as running water or the rustling of a newspaper, uncomfortably loud and sometimes painful. Many people with hyperacusis also experience a feeling of fullness (pressure) in their ear(s).

Action on Hearing Loss, previously known as the RNID, is a well-respected UK charity for those with hearing problems.

What causes hyperacusis?

There seem to be a few different possible causes for hyperacusis and research into the condition is ongoing; again, I'm going to share some information from the Action on Hearing Loss factsheet with you to highlight what these might be:

It’s possible that hyperacusis is a result of a problem with some functions of the hearing system, which normally ‘balance’ sounds and protect the system. When you’re in a noisy environment, your brain sends information about loud noise back to the inner ear, so that the ‘volume’ can be turned down and the inner ear can be protected. Damage to this ‘feedback mechanism’ may be an underlying cause of hyperacusis.

The brain is also responsible for processing the sound signals it receives from the inner ear. Problems in the way these signals are processed could be another cause of hyperacusis.

Recent research indicates that one cause of hyperacusis may be a reduction in a brain chemical that controls the amount of information arriving in the brain from the sense organs. For this reason, some people who have hyperacusis may also have extreme sensitivity to light (photophobia), as seen in those who have migraines.

We also know that some people develop hyperacusis after sudden exposure to very high levels of noise or after a head injury. Such experiences damage delicate structures within the inner ear, leading to increased sensitivity to noise.

The factsheet also states that hyperacusis can be associated with:

migraine

some types of depression

post-traumatic stress disorder

multiple sclerosis

post-head-injury syndrome

Williams’ syndrome

Lyme disease

conditions that prevent the ear’s normal sound protection mechanism from working, such as Bell’s palsy

autistic spectrum disorders

How did you develop hyperacusis?

To this day I am not sure if my development of hyperacusis had a physical or a pyschological cause (or both).

What's undeniable is that during the 2000s, I was exposing my ears to a lot of loud music, and I developed hyperacusis during this period.

However, I have a long history of suffering from anxiety / depression problems, including OCD - and given that there seems to be a link between anxiety/depression and hyperacusis, I sometimes wonder if I became worried about damaging my hearing to the point where my brain effectively started 'telling' me that I had - and making my ears feel painful every time I heard noise.

Certainly the treatment I received focussed very heavily on addressing a fear of sound and getting me used to everyday noise again - and it was when I finally did this that I overcame the condition.

What sort of hyperacusis symptoms did you experience?

For me hyperacusis started with a 'fullness' in one ear when I heard certain sounds (espresso machines, car horns, plates banging together). I then started to experience this in my other ear. After a while the noises that caused the fullness feeling started to cause pain every time I heard them.

Where did you get treatment?

I received excellent care from Britain's National Health Service - an institution that is very dear to my heart (and hearing) - at the Royal London Hospital. The treatment in question was hearing therapy - see below.

(Please note that this hospital will only be able to give you treatment if you live in specific areas of London and have been referred by a relevant GP / ENT).

What did your treatment for hyperacusis entail?

I received hearing therapy. This was a mix of

counselling to help with the psychological and emotional effects of hyperacusis

help and advice regarding practical solutions.

In the counselling sessions, the hearing therapist zoomed in on scenarios and noises where I experienced discomfort or pain in my ears and discussed ways that I could tackle these so that the pain was reduced or eliminated.

She made some specific recommendations, namely:

to stop using earplugs in everyday scenarios (I was told that wearing earplugs can make hyperacusis worse, because when the earplugs are taken out, the brain perceives everyday noises as far louder than they actually are).

The key aims of the session seemed to be to (1) get rid of my fear of sound and (2) regain my tolerance to it.

After a few sessions of hearing therapy my hearing quickly returned to normal. For me personally, I noticed the biggest improvements when

I started to understand that anxiety, not a physical problem, was quite likely to be the cause of my hyperacusis problem

I stopped wearing earplugs in everyday situtations and started to expose my ears to everyday sounds again.

Although taking off my earplugs and exposing my ears to everyday noise again was daunting at first, it was definitely worth it - within a few hours of doing so, I was already noticing drastic improvements.

What treatments are recommended for hyperacusis in general?

The NHS (UK's National Health Service) advises that there are no specific medicines or operations that can be used to tackle hyperacusis, but that treating an underlying cause may help resolve the problem. It recommends:

Cognitive behavioural therapy (CBT) – this aims to help you explore and change the way you think about the troublesome noises to reduce distress, change your avoidance behaviour, and help you recover from your hyperacusis symptoms (this is effectively the treatment I received).

Counselling and education – to support you and help you learn more about your hyperacusis

Sound therapy (desensitisation) – this aims to help desensitise your hearing over several months, using special noise generators either placed in the room or in your ears (similar to hearing aids)

Lifestyle changes – including learning relaxation techniques, listening to calming music or sounds, not avoiding noisy situations, and not using earplugs or muffs (these may make your ears more sensitive)

Have you fully recovered from hyperacusis?

In a word, yes. Everyday sounds don't bother me at all now.

I do sometimes find very loud music (particularly certain instruments and drummers) difficult to be around - but in those situations (and only in those situations) I use special 'musicians earplugs' which reduce the overall volume without dulling frequencies. This is something that is recommended for musicians and gig-goers in general - not just people who suffer from hyperacusis.

As a musician, I am still able to make music and perform live without difficulty.

I think I have hyperacusis. What should I do?

The first thing I'd say is: don't panic. Hyperacusis can be tackled, and overcome. I am living proof of that - my hearing, which I thought was messed up forever, is now completely fine.

The second thing I'd say is to seek medical help from your doctor or ENT (Ear, Nose and Throat) consultant, but crucially, make sure any medical professional you are talking to about hyperacusis actually knows what it is!

Part of the problem I had with hyperacusis was that it's a relatively rare condition, and the doctors - even the ENTs - that I initially spoke to had never heard of it...and as such could not offer any treatment. So make sure that when you go to see your doctor about hyperacusis you are armed with some information about the condition - I'd suggest printing off Action on Hearing Loss' factsheet about it as well as the NHS web page on hyperacusis and bringing both along to your doctor and/or ENT.

And finally, be aware that there is a lot of misinformation about hyperacusis online - you may find people in forums saying that it's a permanent condition, or arguing that wearing earplugs as a way of combating hyperacusis is a good idea (both notions run contrary to all medical advice or research I've encountered about the condition). My advice would be to stick to sources of information from reptuable organisations when researching hyperacusis - like the NHS and Action on Hearing Loss resources shared above - and to try to find qualified medical professionals who can help you recover.

Where can I find out more about hyperacusis?

Here are a few links to resources on hyperacusis from reputable organisations: